“We must carefully choose who we marry.”
My biochemistry professor said this after mentioning sickle cell anemia, which at its most basic definition is a disorder caused by genetic mutation of a protein in red blood cells called hemoglobin. Hemoglobin carries oxygen, but its mutated form changes the shape of red blood cells, making it difficult for them to pass through blood vessels.
I have no doubt my professor knew that sickle cell anemia is an inherited disorder. If a person inherits two copies of mutated hemoglobin genes, they would suffer the disorder, but they would not suffer the disorder if one of the parents contributed a functional and another a mutated hemoglobin gene. In this case, the person would be a carrier and could pass the mutated gene on to their child. A carrier marrying another carrier increases the likelihood their child will suffer the disorder. Even though there are treatments ranging from pain medications, blood transfusions, to stem cells, they are expensive—meaning that the disorder will have a more severe impact on the poor and uninsured.
I was the only person of color in the class. I have no doubt the professor also knew the disorder is concentrated in populations from Africa, Central and South America, Middle East, Asia and the Mediterranean.
Whether the professor was discouraging interracial marriage is not the point. The point is genetic disorders like sickle cell anemia are not sufficient to explain why for instance African Americans are more likely to die during birth, have asthma as kids, have high blood pressure as adults and have Alzheimer’s in elderly years.
A year-long investigation by the Associated Press found that structural racism is a key non-genetic factor driving disproportionate poor health among African Americans.
Let’s now turn to my ally, ChatGPT, to hear thoughts on structural racism and health care in the United States. ChatGPT’s responses are italicized.
How does structural racism affect health care?
Structural racism in health care manifests through disparities in access, treatment and outcomes based on race.
Elaborate on “disparities in access, treatment and outcomes based on race.”
Access: Racial minorities often face barriers to accessing health care services. This can be due to factors like inadequate health insurance coverage, limited availability of health care facilities in predominantly minority neighborhoods, transportation challenges and economic disparities. These barriers prevent many people from seeking timely and preventative care.
Treatment: Once individuals from marginalized racial backgrounds do access health care, they may still experience disparities in the quality of treatment. Bias among health care providers can lead to misdiagnosis, delayed treatment or inappropriate medical recommendations. This bias can affect the decision-making process, potentially resulting in less effective or suboptimal care for minority patients.
Outcomes: Due to disparities in access and treatment, racial minorities often experience worse health outcomes compared to their white counterparts. This includes higher rates of chronic diseases, maternal mortality, infant mortality and lower life expectancy.
How can we dismantle racism in health care?
- Implement mandatory anti-racism training for health care professionals to raise awareness about implicit bias, cultural competence and the impact of racism on health outcomes.
- Collect and analyze health care data by race and ethnicity to identify disparities in access, treatment and outcomes. Use this data to inform targeted interventions.
- Ensure equitable access to health care services, including affordable insurance coverage and facilities in underserved communities.
- Encourage health care providers to understand and respect the diverse cultural backgrounds of their patients. This includes effective communication and sensitivity to cultural differences.
- Involve communities in decision-making processes related to health care policies, programs and resource allocation to address their specific needs.
- Advocate for policies and legislation that address structural racism, such as expanding Medicaid, promoting health equity and anti-discrimination laws.
- Increase diversity among health care professionals and leadership positions to better reflect the communities they serve.
- Empower patients to be advocates for their own health care by providing information, resources and support to navigate the health care system.
- Hold health care institutions accountable for addressing racism within their systems, including consequences for discriminatory practices.
- Invest in research to better understand the root causes of health care disparities and develop evidence-based interventions to address them.
- Raise public awareness about health care disparities and the impact of racism on health outcomes through education campaigns and community outreach.
- Foster collaboration between health care institutions, community organizations, government agencies and advocacy groups to develop holistic approaches to combating racism in health care.
How can AI help?
- Analyze vast datasets to identify patterns of racial disparities in health care access, treatment and outcomes.
- Tailor treatment plans to individual patient profiles, considering genetic, lifestyle and environmental factors, including those associated with racial and ethnic backgrounds.
- Language translation tools can bridge language barriers and promote effective communication between health care providers and patients from diverse linguistic backgrounds.
- Detect bias in clinical decision-making. This can help ensure that patients receive the most appropriate care based on medical evidence rather than subjective factors.
- Optimize resource allocation, ensuring that underserved communities receive the necessary medical facilities, staff and equipment to address their unique health care needs.
Makes so much sense, ChatGPT. Yet universal health care will remain a bridge too far for many.
